Systems and methods for ankle syndesmosis fixation
In one embodiment, a fixation system includes an anchor adapted to be implanted within a first bone, a washer adapted to be associated with a second bone that is to be secured to the first bone, and a suture that is fixedly attached at one end to the anchor and that extends between the anchor and the washer in multiple passes, the suture being adapted to extend through a passage formed in the first and second bones.
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This application claims priority to U.S. Provisional Application Ser. No. 61/496,690, filed Jun. 14, 2011, which is hereby incorporated by reference herein in its entirety.
BACKGROUNDWhen a serious fracture of the ankle occurs, it is common for the syndesmosis ligaments that extend between the fibula and the tibia to be disrupted. In such cases, it is common practice to fix the fibula to the tibia to enable the syndesmosis ligaments to heal. Because the fibula and the tibia move relative to each other during walking and running, the fibula and tibia are typically fixed using a high-strength suture. The suture stabilizes the ankle without preventing the natural relative movement of the bones.
Although the above-described fixation scheme is effective, there are several drawbacks with the current procedures used to achieve that fixation. With current technology, incisions must be made on both sides of the ankle and holes must be drilled entirely through both the fibula and the tibia. In addition, the suture must be manually held under tension while it is manually tied off to complete the fixation. This process often results in unwanted slack being formed in the suture, which reduces the degree of fixation that can be achieved. Furthermore, multiple knots may be required to tie off the suture, and those knots often can be felt and/or seen through the patient's skin.
In view of the above drawbacks, it can be appreciated that it would be desirable to have an alternative system and method for ankle syndesmosis fixation.
The present disclosure may be better understood with reference to the following figures. Matching reference numerals designate corresponding parts throughout the figures, which are not necessarily drawn to scale.
As described above, it would be desirable to have a system and method for ankle syndesmosis fixation that avoids one or more of the drawbacks of current fixation procedures. Disclosed herein are examples of such systems and methods. In some embodiments, an ankle syndesmosis fixation system comprises an anchor that can be implanted within the tibia and a washer that can be associated with (e.g., implanted within) the fibula. A high-strength suture extends between the anchor and the washer and is threaded through those elements such that, when the suture is pulled, the washer is automatically moved closer to the anchor to fix the fibula to the tibia. In some embodiments, the suture can only pass through the washer in one direction such that the length of the suture extending between the anchor and washer will not slacken when the suture is released. Because of such functionality, the suture can simply be pulled through the washer, tensioned to a desired degree, and cut. Therefore, there is no need to manually maintain the tension in the suture or to tie knots in the suture.
In the following disclosure, various embodiments are described. It is to be understood that those embodiments are merely example implementations of the disclosed inventions and that alternative embodiments are possible. Applicant intends the scope of this disclosure to extend to such embodiments.
The washer 24, which is also shown in end view in
With continued reference to
Turning to
With continued reference to
In some embodiments, at least one of the passages of the washer 24 is a one-way passage such that the suture 40 can only pass through the passage in one direction. By way of example, the passage 48 is a one-way passage that comprises a neck 68 that enables the suture 40 to be pulled in the direction of the arrow 66, but prevents the suture from being pulled in the opposite direction (i.e., toward the anchor). In such a case, the ankle syndesmosis fixation system 30 automatically holds whatever tension that is created by the surgeon by pulling on the suture 40.
As is further illustrated in
After the incision has been made, a passage 86 is formed through the fibula 82 and the tibia 84, as shown in
Once the passage 86 has been formed, the anchor 22 can be positioned within the tibia 84 by passing it through the passage 86 using the shaft 14 of the device 10, as shown in
Referring next to
At this point, the washer 24 can be positioned relative to the fibula 82. In particular, the washer 24 can be pulled in closer to the fibula 82 by pulling the suture 40 in the manner described above in relation to
The washer 24 travels along the shaft 14 toward the fibula 82, as indicated in
At this point, the anchor 22 can be detached from the shaft 14 of the device 10. In some embodiments, such detachment is achieved by squeezing the trigger 18 a second time. Once the anchor 22 has been detached, the shaft 14 can be withdrawn from the passage 86, as shown in
Although this disclosure is focused on the example of ankle syndesmosis fixation, it is noted that the systems and methods could be used in other applications. For example, similar fixation can be in relation to the ulna and radius of the arm.
Claims
1. A fixation system comprising:
- an anchor adapted to be implanted within a first bone, the anchor having a body and a pointed or rounded tip;
- a washer adapted to be associated with a second bone that is to be secured to the first bone, the washer having a body that is adapted to be implanted within the second bone and a flange positioned at an end of the washer body that is adapted to be positioned outside of the second bone, the washer further having a one-way passage comprising an integral feature through which a suture can only physically pass in one direction; and
- a suture that is fixedly attached at one end to the anchor and that passes through the one-way passage of the washer, wherein pulling of the suture through the one-way passage pulls the anchor and the washer closer to each other.
2. The system of claim 1, wherein the body of the anchor is generally cylindrical.
3. The system of claim 1, wherein the anchor comprises only one passage through which the suture passes.
4. The system of claim 3, wherein the passage within the anchor is a U-shaped passage.
5. The system of claim 1, wherein the body of the washer is generally cylindrical.
6. The system of claim 1, wherein the washer comprises multiple passages through which the suture passes.
7. The system of claim 1, wherein the suture is a high-strength suture.
8. The system of claim 1, wherein the suture comprises a multi-stranded core surrounded by a braided jacket.
9. The system of claim 1, further comprising an implantation device used to implant the anchor and the washer, the device including an elongated shaft that supports the anchor and washer during the implantation procedure.
10. The system of claim 9, wherein the implantation device comprises a trigger that, when actuated, deploys anchoring prongs of the anchor.
11. The system of claim 9, wherein the implantation device comprises a trigger that, when actuated, releases the anchor from the device.
12. The system of claim 9, wherein the implantation device comprises a knob that, when turned, pulls the suture and thereby moves the washer closer to the anchor.
13. The system of claim 1, wherein the flange of the washer is generally perpendicular to the body of the washer.
14. The system of claim 1, wherein the washer comprises a central passage that extends along a central longitudinal axis of the body and two peripheral passages that are parallel to the central passage.
15. The system of claim 14, wherein the washer comprises no other passages.
16. The system of claim 14, wherein the central passage of the washer is the one-way passage.
17. The system of claim 1, wherein the anchor comprises deployable anchoring prongs can be moved from a position in which they are retracted relative to the anchor body to a position in which they are extended relative the anchor body.
18. The system of claim 1, wherein the integral feature is a neck of the passage.
19. An ankle fixation system comprising:
- an anchor adapted to be implanted within a tibia, the anchor having a cylindrical body, a pointed or rounded tip, and deployable anchoring prongs that can be moved from a position in which they are retracted relative to the body to a position in which they are extended relative to the body;
- a suture that is fixedly attached at one end to the anchor; and
- a washer having a first end and a second end, the washer further having a body that forms the first end and that is adapted to be implanted within a fibula to be secured to the tibia and a flange that forms the second end and that is adapted to be positioned outside of the fibula, the washer further comprising a one-way passage through which a suture can only pass in a direction extending from its first end to its second end, the one-way passage comprising a neck through which the suture can only physically pass in one direction;
- wherein pulling of the suture through the one-way passage pulls the anchor and washer closer to each other.
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Type: Grant
Filed: Jun 14, 2012
Date of Patent: Mar 8, 2016
Patent Publication Number: 20130030480
Assignees: University of South Florida (Tampa, FL), The United States Government as Represented by the Department of Veterans Affairs (Washington, DC)
Inventors: Guillermo Donate (Tampa, FL), Melissa Abercrombie (Wesley Chapel, FL)
Primary Examiner: Christopher Beccia
Assistant Examiner: Diana S Jones
Application Number: 13/523,246
International Classification: A61B 17/04 (20060101); A61B 17/80 (20060101);